There are several different approaches currently used for the treatment of port-wine stain (PWS) including various laser and light modalities; however, none can truly effectively address this common vascular malformation.
While approximately 80% of port-wine stains improve with laser treatment, less than 20% clear completely, begging the need for more optimal treatment solutions. According to one expert, much more can be done to achieve better outcomes.
“Port-wine stains are not a solved problem and to date, while there are good laser treatment options, multiple treatments are required. Most PWS do not clear completely and a cure for PWS remains elusive. Continued research, however, has born new and exciting strategies for PWS, some of which could prove to be much more effective than the currently used treatment approaches,” says Iris Kedar Rubin M.D., assistant clinical professor of dermatology, George Washington University.
Port-wine stains is a commonly seen vascular malformation involving post-capillary venules. Most frequently occurring on the head and neck, these lesions will typically darken over time and may become hypertrophic and nodular with age, and hence more difficult to treat, underscoring the need for an early therapeutic intervention.
Current treatment modalities such as the pulsed dye lasers have been shown to be effective in the treatment of PWS, however, according to Dr. Rubin, these treatments are far from optimal because complete clearance is only achieved in less than 20% of patients. Moreover, multiple treatment procedures are required, which can be painful for young patients or it may require repeated anesthetics. Those patients who do not achieve clearance require many maintenance treatments throughout their lifetime.
“When we take a pulsed dye laser to an adult or a child’s skin, we are taking our best guess concerning the treatment parameters. We are guessing as to what the sizes of the vessels are in the target region, as well as the depth and configuration of the vessels. Is that good enough? In my opinion, we can do better and need to re-think our current strategies for PWS,” Dr. Rubin says.